NJ Doctor Shortage

[chanel]

In a 2009 report on the condition of the state's physician workforce, the New Jersey Council of Teaching Hospitals projected that, based on then-current trends, the state will be 2,800 physicians short of what it will need to meet growing patient demand by 2020.

Simply put, Goldstein wrote, many other states offer their physicians richer loan repayment programs, better Medicaid rates, lower tax and malpractice liability burdens, more prompt HMO reimbursement requirements and less red tape than New Jersey.

Additionally, New Jersey is a high-tax state, placing yet another financial disincentive for new physicians to open up a practice here, Cinotti said.

In the physician and malpractice insurance community, New Jersey has the reputation of being a "judicial hellhole," she said.

When you talk to practicing physicians, they'll tell you how hard they work to discourage their children from going into medicine," Costante said.

N.J. faces growing shortage of doctors due to med school costs, insurance concerns | NJ.com

I'm sure Obamacare will address all of the issues, right?

 

[Madeline]

In a 2009 report on the condition of the state's physician workforce, the New Jersey Council of Teaching Hospitals projected that, based on then-current trends, the state will be 2,800 physicians short of what it will need to meet growing patient demand by 2020.

Simply put, Goldstein wrote, many other states offer their physicians richer loan repayment programs, better Medicaid rates, lower tax and malpractice liability burdens, more prompt HMO reimbursement requirements and less red tape than New Jersey.

Additionally, New Jersey is a high-tax state, placing yet another financial disincentive for new physicians to open up a practice here, Cinotti said.

In the physician and malpractice insurance community, New Jersey has the reputation of being a "judicial hellhole," she said.

When you talk to practicing physicians, they'll tell you how hard they work to discourage their children from going into medicine," Costante said.

N.J. faces growing shortage of doctors due to med school costs, insurance concerns | NJ.com

I'm sure Obamacare will address all of the issues, right?

Even the megabill known as Obamacare doesn't address every single aspect of health care, chanel. There's already expected to be MD shortages in some sectors of the practice, most especially family physicians. If NJ cannot compete against other states for MDs, it is not unreasonable to be concerned.

What would you like to see done to correct this?

 

[chanel]

Number One - tort reform. NJ is one of the most litigious states in the country. We have two OB/Gyns in town that will no longer deliver babies.

I said a few weeks ago that I have close friends who are physicians and have discouraged their own children from going into medicine. Looks like this study says the same damn thing.

I don't believe Obamacare addresses that does it?

 

[Madeline]

Number One - tort reform. NJ is one of the most litigious states in the country. We have two OB/Gyns in town that will no longer deliver babies.

I said a few weeks ago that I have close friends who are physicians and have discouraged their own children from going into medicine. Looks like this study says the same damn thing.

I don't believe Obamacare addresses that does it?

No, as far as I know tort reform is not in that law.

I am a huge opponent of tort reform for med mal. I really, really, really hate the idea of slamming shut the courthouse doors on people injured or killed by doctors.

BUT

I could be mollified a bit if the state licensing board were remade to include some non-medical types and the disciplinary standards were tightened. If you will no longer allow Jane Doe to recover for injuries she suffered at the hands of her MD, can we at least agree to prevent that same doctor from injuring a second patient?

Seems to me the income tax and student loan subsidy laws are easy to modify, as long as the state can pay the freight this will cost. Changing your Medicaid reimbursement rates will be a bitchkitty, though.

My Google-Fu has failed; I cannot find a chart of the various states' levels of Medicaid reimbursement. But let's assume, for argument's sake, that New Jersey is dead last. Any effort New Jersey makes to enrich its Medicaid rates is going to cost it hugely. If the rates just went up by 1 penny per claim, that might could be hundreds of thousands of dollars, as the state almost certainly has nearly a billion such claims a year -- mebbe more.

It's a difficult problem, that's for sure.

 

[Greenbeard]

I'm sure Obamacare will address all of the issues, right?

Every health care workforce bill introduced in the last session of Congress was rolled into the ACA. Will that be enough? No. But like most of the delivery system pieces in it, that's meant to be a start--a first step toward addressing issues that have been ignored for far too long.

As for tort reform, the ACA contains exactly the same approach to tort reform contained in Paul Ryan and Tom Coburn's health reform bill: federal money to encourage states to try implementing new approaches to tort law at the state level.

Ryan's bill:

`(a) In General- The Secretary may award grants to States for the development, implementation, and evaluation of alternatives to current tort litigation that comply with this section, for the resolution of disputes concerning injuries allegedly caused by health care providers or health care organizations.

`(b) Conditions for Demonstration Grants- ...​

The ACA:

`(a) In General- The Secretary is authorized to award demonstration grants to States for the development, implementation, and evaluation of alternatives to current tort litigation for resolving disputes over injuries allegedly caused by health care providers or health care organizations.​

Lost in all the bullshit about the ACA being written behind closed doors is the fact that one of the reasons it's so long is that it cannibalized many of the health care bills (or pieces of them) introduced in the last session, including the workforce bills and even pieces of Paul Ryan's bill (you know, the one based on building state-based health insurance exchanges--damn, that sounds familiar).

But of course that's not satisfying. When the GOP's Golden Boy of the Budget introduces the idea it's thought-provoking; when the Democratic majority passes it, it's limp-wristed.

Anyway, looks like New Jersey currently ranks number 9 in doctors per capita in the country.